Snap Shot A 44-year-old male presents to his primary care physician complaining of vague abdominal pain, nausea, and vomiting. He reports that he has noticed that his shoes no longer seem to fit and wonders if he might have venous insufficiency. Hemoccult stool is positive. Introduction Hypertrophic gastropathy secondary to hyperplasia of mucus-producing cells Increased mucin production leads to protein loss Little or no acid production login to view 1 more bullet Rare acquired premalignant stomach disease Associated with H. pylori and CMV infections Caused by login to view 1 more bullet Etiology unknown, but pathophysiology linked to epidermal growth factor receptor (EGFR) ligand Presentation Symptoms login to view 6 more bullets Physical exam login to view 2 more bullets Evaluation Endoscopy with deep mucosal biopsy Gross appearance login to view 1 more bullet Microscopic appearance login to view 1 more bullet Labs login to view 2 more bullets Treatment Medical management login to view 8 more bullets Surgery login to view 3 more bullets Prognosis, Prevention, and Complications ↑ risk of adenocarcinoma anastomotic leak and fistula is problem with subtotal gastrectomy